Dual Specific Immunotoxin for Brain Tumor Therapy

ABSTRACT

We tested the in vitro and in vivo efficacy of a recombinant bispecific immunotoxin that recognizes both EGFRwt and tumor-specific EGFRvIII receptors. A single chain antibody was cloned from a hybridoma and fused to toxin, carrying a C-terminal peptide which increases retention within cells. The binding affinity and specificity of the recombinant bispecific immunotoxin for the EGFRwt and the EGFRvIII proteins was measured. In vitro cytotoxicity was measured. In vivo activity of the recombinant bispecific immunotoxin was evaluated in subcutaneous models and compared to that of an established monospecific immunotoxin. In our preclinical studies, the bispecific recombinant immunotoxin, exhibited significant potential for treating brain tumors.

This application claims the benefit of provisional application Ser. No.61/044,190 filed Apr. 11, 2008, the contents of which are expresslyincorporated herein.

TECHNICAL FIELD OF THE INVENTION

This invention is related to the area of anti-tumor immunotoxins. Inparticular, it relates to an immunotoxin specific for twotumor-associated antigens.

BACKGROUND OF THE INVENTION

Gliomas are the most common primary tumors of the central nervous system(CNS) {Louis, 1995}. Glioblastoma multiforme (GBM) is the most frequentand the most malignant type of glioma. There is a much higher incidenceof GBM in adults than in children. According to the Central Brain TumorRegistry of the United States statistical report, GBM accounts for about20% of all brain tumors in the USA (CBTRUS, 1998-2002). Currenttreatment for patients with GBM include, surgery followed by radiationand chemotherapy. Despite intensive research the median survival for GBMpatients until the early 1990s was less than a year {Walker, 1978}. Thesingle most important advance in the treatment of these tumors over thepast 30 years has been the introduction of temozolomide, initially incombination with external beam irradiation, and then followed byrepetitive cycles of temozolomide alone {Stupp, 2007}. However, this hasincreased the overall median survival by only 75 days. Clearly, new andmore efficient therapeutic approaches are needed to improve GBM patientsurvival. Monoclonal antibodies (mAbs), either armed (fused toimmunotoxin [IT] or radioisotopes) or unarmed, are presently a rapidlygrowing category of new drug entities. This is well demonstrated by thelarge number of mAb-based clinical trials currently in progress forbrain tumor patients. Boskovitz, A., Wikstrand, C. J., Kuan, C. T.,Zalutsky, M. R., Reardon, D. A., and Bigner, D. D. Monoclonal antibodiesfor brain tumour treatment. Expert Opin Biol Ther, 4: 1453-1471, 2004.More recently, genetically engineered single-chain variable-regionantibody fragments (scFvs), consisting of the heavy- and light-chainvariable regions (V_(H) and V_(L)) fused to toxins and targetingantigens expressed specifically by brain tumor, are under investigation.Archer, G. E., Sampson, J. H., Lorimer, I. A., McLendon, R. E., Kuan, C.T., Friedman, A. H., Friedman, H. S., Pastan, I. H., and Bigner, D. D.Regional treatment of epidermal growth factor receptor vIII-expressingneoplastic meningitis with a single-chain immunotoxin, MR-1. Clin CancerRes, 5: 2646-2652, 1999. Because it is small, an scFv-IT fusion proteinshould have greater tumor penetration than an intact IgG and thereforelead to enhanced therapeutic efficacy {Pastan, 1995}.

The epidermal growth factor receptor (EGFR) is a 170-kDa, transmembranereceptor tyrosine kinase (RTK). It is stimulated by binding of itsligands, such as transforming growth factor (TGF)-α or EGF, to itsextracellular domain. Ligand binding induces receptor dimerization andactivates a tyrosine-specific protein kinase activity {Ushiro, 1980}involved in controlling epithelial cell growth and proliferation.Ultimately, the receptor-ligand complexes are internalized, and the EGFRsignal is terminated. EGFR overexpression is frequently observed in awide variety of human cancers, including breast {Klijn, 1992; Osaki,1992}, lung {Pavelic, 1993}, head and neck {Rubin Grandis, 1996},prostate {Fox, 1994}, bladder {Chow, 2001}, colorectal {Yasui, 1988},and ovarian carcinoma {Bartlett, 1996}, as well as brain tumors {Arita,1989; Libermann, 1984}. In contrast, the level of EGFR in normal brainis undetectable or extremely low. EGFR is the most frequently amplifiedgene in GBM {Fuller, 1992}. Correlating with the gene amplification, theprotein is overexpressed in about 60% to 90% of GBM cases. In theabsence of gene amplification, protein overexpression has also beenobserved in 12% to 38% of GBM patients {Chaffanet, 1992}, which could bedue to aberrant translational and post-translational mechanisms.Preclinical studies have shown that EGFR activation, in addition toprotecting cells from apoptosis, also induces several tumorigenicprocesses, including proliferation, angiogenesis, and metastasis {Huang,1999}.

EGFR gene amplification is often associated with gene rearrangements.Several EGFR deletion mutants have been identified {Rasheed, 1999}, themost common one being EGFRvIII, which is present in 20% to 50% of GBMswith EGFR amplification. Wikstrand, C. J., Fung, K. M., Trojanowski, J.Q., McLendon, R. E., and Bigner, D. D. Antibodies and molecularimmunology: immunohistochemistry and antigens of diagnosticsignificance. In: D. D. Bigner, R. E. McLendon, and J. M. Bruner (eds.),Russell and Rubinstein's Pathology of the Nervous System, 6th edition,pp. 251-304. New York: Oxford University Press, 1998. The mutantEGFRvIII contains a deletion of exon 2-7 of the EGFR gene, which ischaracterized by an in-frame deletion of 801 base pairs of the codingregion {Sugawa, 1990}. This deletion creates a novel glycine residue atthe fusion junction at position 6, between amino acid residues 5 and274, generating a tumor-specific protein sequence that is expressedspecifically on tumor cells but not on normal tissues. EGFRvIII is aconstitutively active RTK which is not further activated by EGFRligands. Batra, S. K., Castelino-Prabhu, S., Wikstrand, C. J., Zhu, X.,Humphrey, P. A., Friedman, H. S., and Bigner, D. D. Epidermal growthfactor ligand-independent, unregulated, cell-transforming potential of anaturally occurring human mutant EGFRvIII gene. Cell Growth Differ, 6:1251-1259, 1995. EGFRvIII is widely expressed in malignant gliomas{Humphrey, 1990} and carcinomas. including head and neck {Sok, 2006} andbreast. Wikstrand, C. J., Hale, L. P., Batra, S. K., Hill, M. L.,Humphrey, P. A., Kurpad, S, N., McLendon, R. E., Moscatello, D., Pegram,C. N., Reist, C. J., and et al. Monoclonal antibodies against EGFRvIIIare tumor specific and react with breast and lung carcinomas andmalignant gliomas. Cancer Res, 55: 3140-3148, 1995. Overexpression ofEGFRvIII induces resistance in glioma cells to commonly usedchemotherapeutic agents {Nagane, 1998}.

Monoclonal antibodies targeting either the wild-type EGFR (EGFRwt) orEGFRvIII have been developed. One of them, D2C7, a murine IgG1κ, wasdeveloped by our group. The D2C7 hybridoma recognizes both the EGFRwtand the tumor-specific EGFRvIII receptors {Boskovitz, 2005}.

There is a continuing need in the art for effective means of treatingbrain tumors and prolonging life of affected patients.

SUMMARY OF THE INVENTION

According to one embodiment of the invention a single chain variableregion antibody is provided. The antibody binds with a binding affinitythat is at least 5×10⁸ M⁻¹ as measured by surface plasmon resonance toboth (a) EGFR found on normal human cells and (b) EGFR variant IIImutant.

According to another embodiment a method is provided of treating a tumorin a human. A single chain variable region antibody is administered tothe human. The antibody binds with a binding affinity that is at least5×10⁸ M⁻¹ as measured by surface plasmon resonance to both (a) EGFRfound on normal human cells and (b) EGFR variant III mutant. Tumor cellsare thereby killed.

According to yet another embodiment of the invention a monoclonalantibody is provided that binds with a binding affinity that is at least5×10⁸ M⁻¹ to both (a) EGFR found on normal human cells and (b) EGFRvariant III mutant. The antibody has a V_(H) sequence as shown in FIG.1A (SEQ ID NO: 1), a V_(L) sequence as shown in FIG. 1B (SEQ ID NO: 2),or CDR1, CDR2, and CDR3 regions as shown in FIG. 1A (SEQ ID NO: 3, 4, 5)and lB (SEQ ID NO: 6, 7, 8).

Yet another embodiment of the invention provides a monoclonal antibodythat binds with a binding affinity that is at least 1×10⁸ M⁻¹ to both(a) EGFR found on normal human cells and (b) EGFR variant III mutant.The antibody is selected from the group consisting of F2A2 and B10B11.

An additional embodiment of the invention provides a method ofdetermining a therapeutic plan to treat a tumor in a human. Tissue ofthe tumor is contacted with an antibody that binds with a bindingaffinity that is at least 1×10⁸ M⁻¹ to both (a) EGFR found on normalhuman cells and (b) EGFR variant III mutant. The amount of cells in thetissue that bind to the antibody is determined. Greater amounts of cellswhich bind are a positive factor to recommend using the antibodytherapeutically for the patient.

These and other embodiments which will be apparent to those of skill inthe art upon reading the specification provide the art with methods andreagents for treating brain tumors.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A-1B. Deduced amino acid sequence of D2C7 scFv cloned from D2C7hybridoma. V_(H) (FIG. 1A) and V_(L) (FIG. 1B) antigen-binding regionsof D2C7 scFv. Amino acid numbering and CDR (underlined) delimitationwere determined according to the IMGT database.

FIG. 2. Schematic of D2C7 (scdsFv)-PE38 KDEL. The arrow marks theproteolytic site of PE for activation. S—S shows the disulfide bondlinkage between the Fv fragments. II, PE domain II for translocation;III, PE domain III for ADP-ribosylation of EF2, KDEL, for increasedendoplasmic reticulum retention.

FIG. 3A-3B. Biacore analysis of D2C7 (scdsFv)-PE38 KDEL. Bindingkinetics and affinity constants of D2C7 (scdsFv)-PE38 KDEL for EGFRwt(FIG. 3A) and EGFRvIII (FIG. 3B) were determined by surface plasmonresonance against bacterially expressed recombinant EGFRwt or EGFRvIIIextracellular domain proteins. The association and dissociation ratesfrom the sensogram were KA=6.3×10⁸ M⁻¹ and KD=1.6×10⁻⁹ M against EGFRwtand KA=7.8×10⁸ M⁻¹ and KD=1.3×10⁻⁹ M against EGFRvIII.

FIG. 4A-4C. Flow cytometric analysis of D2C7 (scdsFv)-PE38 KDELimmunotoxin to determine reactivity of the D2C7 IT. (FIG. 4A) ParentalNR6 (NIH 3T3 murine fibroblast) cells used as control. Indirect FACSanalysis demonstrates the reactivity of D2C7 (scdsFv)-PE38 KDELimmunotoxin with cells expressing (FIG. 4B) EGFRwt (NR6W) or (FIG. 4C)EGFRvIII (NREM). Cells were stained with D2C7 (scdsFv)-PE38 KDEL (greyopen peaks) or a non-specific scFv (anti-Tac-PE38 KDEL) control (filledblack peaks).

FIG. 5A-5C. In vitro cytotoxicity assay of D2C7 (scdsFv)-PE38 KDEL on(FIG. 5A) NR6, (FIG. 5B) NR6W, and (FIG. 5C) NR6M cells. The cytotoxiceffect of D2C7-PE38 (▴) and D2C7 (scdsFv)-PE38 KDEL () was compared tothat of an established EGFRvIII-specific scFv immunotoxin,MR1-1-(scdsFv)-PE38 KDEL (x). A non-specific scFv anti-Tac-PE38 (▪) wasused as a control. At least three different assays were performed foreach cell line, and results from one representative experiment areshown.

FIG. 6A-6E. In vitro cytotoxicity of F2A2 on A431P and D270MG (FIG.6A-6B) and on NR6, NR6W, and NR6M (FIG. 6C-6E).

FIG. 7A-7V. Expression of tumor antigens and CD133 analyzed by flowcytometry.

DETAILED DESCRIPTION OF THE INVENTION

It is a discovery of the present inventors that antibodies can bind withcomparable and high affinities to both EGFR found on normal cells and toEGFR variant III. By virtue of binding to both forms of EGFR, theseantibodies can induce cytotoxicity in a higher percentage of cellswithin a tumor. Moreover, high affinity binding of the antibodies to thecell surface receptors permits and enhances antibody internalization,again increasing their cytotoxic effect.

Antibodies which have been identified which have excellent properties inthis regard include D2C7, F2A2, B10B11, and H11 (Life Span Biosciences,Inc. Seattle, Wash.). These are mouse monoclonal antibodies produced byhybridomas. These antibodies can be “converted” into other forms, forexample, humanized, chimeric, and single chain variable regionantibodies. These conversions are well known in the art and typicallyinvolve cloning of the antibody encoding genes from the hybridomas whichproduced the mouse monoclonal antibodies. If the VH or VL or the CDRregion sequences remain the same as in the original monoclonal antibody,then the antibody may have retain binding specificity.

Such antibodies and “converted” antibodies can be bound, eithercovalently or non-covalently, to other useful moieties. For example,they can be conjugated to radionuclides or radioactive moieties. Theycan be joined to a biological toxin, such as Pseudomanas exotoxin A,ricin, or diphtheria toxin. They can be conjugated to chemotherapeuticagents. They can be joined to other antibodies. Attachments of theantibodies to other moieties can occur by means of genetic engineering,if the other moiety is a protein, so that a fusion protein is producedin a host cell. The attachments may be done chemically, in vitro. Theattachments may be covalent or non-covalent. Non-covalent attachmentspreferably use strong biological specific binding pairs to achievestrong attachments. For diagnostic purposes, the antibodies can beattached to chromophores, or other easily detectable moieties.

Other moieties which can be attached to the antibodies include those toprovide additional beneficial properties. For example, a KDEL(lys-asp-glu-leu) tetra-peptide can be added at the carboxy-terminus ofthe protein to provide retention in the endoplasmic reticulum. Variantssuch as DKEL, RDEL, and KNEL which function similarly can also be used.

Binding affinities can be measured by any means known in the art. Oneparticular method employs surface plasmon resonance. Binding affinitieswithin one log for wild-type and mutant EGFRvIII are desirable, as arethose within 50%, 75%, and 90% of each other. Binding to cells can bemeasured, for example by flow cytometry. Association and dissociationrates can be determined. Affinity constants can be calculated. Thekinetics of binding may be a significant factor in cytotoxicity in thebody. Binding affinities may be at least 1×10⁸ M⁻¹, at least 5×10⁸ M⁻¹,at least 1×10⁹ M⁻¹, or at least 5×10⁹ M⁻¹. Techniques can be used to“affinity mature” i.e., improve affinity of, candidate antibodies.

Tumors which can be treated include those in which at least one EGFRvIIIallele is present. These may be found in breast, head and neck, brain,glioblastoma multiforme, astrocytoma, lung, or other tumors. It may bedesirable to determine the presence of such an allele prior to therapy.This can be done using a oligonucleotide-based technique, such as PCR,or using an immunological technique, such as immunohistochemistry. Itmay be desirable to determine the amount, fraction, ratio, or percentageof cells in the tumor which express EGFR and/or EGFRvIII. The more cellswhich express EGFR on their surfaces, the more beneficial such antibodytherapy is likely to be.

Antibodies and antibody constructs and derivatives can be administeredby any technique known in the art. Compartmental delivery may bedesirable to avoid cytotoxicity for normal tissues that express EGFR.Suitable compartmental delivery methods include, but are not limited todelivery to the brain, delivery to a surgically created tumor resectioncavity, delivery to a natural tumor cyst, and delivery to tumorparenchyma.

The above disclosure generally describes the present invention. Allreferences disclosed herein are expressly incorporated by reference. Amore complete understanding can be obtained by reference to thefollowing specific examples which are provided herein for purposes ofillustration only, and are not intended to limit the scope of theinvention.

Example 1 Materials and Methods

Cell Lines.

Cell lines expressing EGFRwt used were the human epidermoid carcinomacell line A431 {Merlino, 1984} and the murine Swiss 3T3 mouse fibroblastcell line EGFRwt transfectant NR6W {Batra, 1995}. Cell lines transfectedto express EGFRvIII included the murine Swiss 3T3 mouse fibroblast cellline-derived transfectant NREM {Batra, 1995}. The parental murine Swiss3T3 mouse fibroblast cell line, NR6, was used as control. All cell lineswere cultured in complete zinc option-10% fetal bovine serum (FBS)(Richter's zinc option; Invitrogen, San Diego, Calif.) and passed atconfluence using 0.05% Trypsin-EDTA (Invitrogen).

Disaggregation of Xenograft Tumor Samples.

Xenograft tissues from malignant glioma (D256MG, D270MG, D2159MG)obtained under sterile conditions from the Duke animal facility wereprepared for cell culture in a laminar flow hood with a steriletechnique. Tumor material was finely minced with scissors and added to atrypsinizing flask with approximately 10 ml of 100 μg Liberase (RocheIndianapolis, Ind.). This mixture was stirred at 37° C. for 10 min, anda cell-rich supernatant was obtained. The dissociated cells werefiltered through a steel sieve with 100 mesh wire. The reaction wasinhibited with the addition of the ovomucoid solution. The cells werewashed with complete medium and pelleted at 1000 rpm for 5 min. The cellsuspension was further treated with Ficoll-Hypaque to remove any redblood cells and then washed once in complete media. The cells werecultured and passaged until sufficient numbers were obtained (firstadherent population, p0; subsequent passages, p1, p2, and so forth). Theattached cells were harvested with 0.05% Trypsin-EDTA.

Cloning of Variable Heavy (V_(H)) and Variable Light (V₁) Domains of theD2C7 mAb.

Total cellular mRNA was isolated from 10⁶ hybridoma cells by using aDynabeads, mRNA direct kit (Invitrogen). V_(H) and V_(L) cDNAs of theD2C7 mAb were obtained by a RACE method using a SMART RACE cDNAamplification kit (Clontech, Palo Alto, Calif.). In brief,adaptor-ligated cDNA was generated from 300 ng of the mRNA by usingPowerScript Reverse Transcriptase and SMART II A oligonucleotide(Clontech), along with 12 μM each of 3′ end primers designed to annealthe heavy-chain (HC) and light-chain (LC) constant region sequence ofimmunoglobulin (mouselgGl/2: 5′-CTGGACAGGGATCCAGAGTTCCA-3′ (SEQ ID NO:9) and mouseLC: 5′-CTCATTCCTGTTGAAGCTCTTGAC-3′; SEQ ID NO: 10). Theprimers covered the constant region sequences registered in the Kabatdatabase. The prepared cDNAs were used as the templates for PCRreactions between 5′ end primer which binds to the adaptor sequence andthe immunoglobulin HC- and LC-specific 3′ end primer specified above.The obtained sequences were aligned and verified according to the Kabatalignment scheme. The V_(H) domain was fused to the V_(L) domain by a15-amino-acid peptide (Gly₄Ser)₃ (SEQ ID NO: 11) linker by PCR. The D2C7scFv fragment was cloned into pRK79 vector using a T4 DNA ligase kit(Pierce Biotechnology, Rockford, Ill.). The D2C7 (scdsFv) construct wasobtained by mutating residues 44 of V_(H) and 100 of V_(L) bysite-directed mutagenesis using a QuickChange Multi-Site DirectedMutagenesis Kit (Stratagene, La Jolla, Calif.). The D2C7-(scdsFv)-PE38KDEL IT was obtained by ligating the D2C7 (scdsFv) PCR fragment intopRB199 vector, and the sequence was verified. The MR1-1-(scdsFv)-PE38KDEL IT was obtained by ligating the MR1-1 (scdsFv) PCR fragment intopRB 199 vector, and the sequence was verified.

Preparation of Recombinant Immunotoxins.

The different D2C7 ITs were generated by fusing the specific scFv withthe sequences for domains II and III of Pseudomonas exotoxin A (PE38)according to the protocol described previously {Buchner, 1992}. Thespecific scFv IT was expressed under control of the T7 promoter in E.coli BL21 (λ DE3) (Stratagene, La Jolla, Calif.). All recombinantproteins accumulated in the inclusion bodies. The ITs were then reduced,refolded, and further purified as a monomer (64 kDa) by ion exchange andsize exclusion chromatography to greater than 95% purity.

Surface Plasmon Resonance (Biacore Analysis).

Binding kinetic profiles of purified D2C7-(scdsFv)-PE38 KDEL IT weremeasured by surface plasmon resonance by using a Biacore 3000 biosensorsystem (Pharmacia, Uppsala, Sweden). As an antigen, either EGFRwtextracellular domain (ECD) or EGFRvIII ECD proteins were immobilized onthe surface of the CM5 sensor chip at pH 5.5. Test samples were dilutedin running buffer (10 mM HEPES/150 mM NaCl/3.4 mM EDTA, pH 7.4) andpassed over the chip at concentrations from 25 to 200 nM. Theassociation and dissociation rate constants and the average affinitywere determined by using the nonlinear curve-fitting BIAevaluationsoftware (Pharmacia).

Flow Cytometry.

Indirect FACS analysis was performed with D2C7-(scdsFv)-PE38 KDEL IT.Briefly, 1×10⁶ cells (NR6, NR6W, or NREM) were suspended in 500 μl ofPBS (Invitrogen) containing 5% FBS (Invitrogen) (5% FBS/PBS). TheD2C7-(scdsFv)-PE38 KDEL IT or negative control, anti-Tac(scFv)-PE38 (agift from Dr. Ira Pastan), was added to the cells at a concentration of10 μg/ml, and the samples were incubated for 40 min. After washing,cells were incubated with rabbit anti-Pseudomonas exotoxin A antibody(Sigma, St. Louis, Mo.) followed by labeling with FITC-conjugated goatanti-rabbit IgG antibody (Zymed, South San Francisco, Calif.). Toprevent internalization of target antigens during assays, all thereagents and buffers were kept on ice, and experiments were performed at4° C. Stained cells were analyzed on a Becton Dickinson FACSortinstrument equipped with CellQuest software (Becton Dickinson, San Jose,Calif.).

In Vitro Cell Killing Assay.

The cytotoxicity of the ITs on cultured cell lines and cells isolatedfrom xenografts was assayed by inhibition of protein synthesis asdescribed previously {Beers, 2000}. Cells were seeded in 96-well platesat a density of 2×10⁴ cells per well in 200 μl of complete zinc optionmedium 24 h before the assay. Immunotoxins were serially diluted toachieve a final concentration of 0.01 to 1000 ng/ml in PBS containing0.2% bovine serum albumin (BSA; 0.2% BSA/PBS), and 10 μl of dilutedtoxin was added to each well. Plates were incubated for 20 h at 37° C.and then pulsed with 1 μCi/well of L-[4,5-³H]leucine (AmershamBiosciences, Buckinghamshire, UK) in 25 μl of 0.2% BSA/PBS for 3 h at37° C. Radiolabeled cells were captured on filter-mats and counted in aMicroBeta scintillation counter (PerkinElmer, Shelton, Conn.). Thecytotoxic activity of an IT was defined by IC₅₀, which was the toxinconcentration that suppressed incorporation of radioactivity by 50% ascompared to the radioactivity measured in cells that were not treatedwith toxin.

Determination of Nonspecific Toxicity in Mice.

The single-dose mouse LD₄₀ was determined by using female BALB/c mice(6-8 weeks old, 20 g), which were given a single intraperitoneal (i.p.)injection of different doses of D2C7-(scdsFv)-PE38 KDEL IT (0.25 to 1.25mg/kg) diluted in 200 μl of PBS containing 0.2% human serum albumin(PBS-HSA). Mice were observed for 2 weeks following IT injection.

In Vivo Tumor Model.

Female athymic nude mice (approximately 20 g body weight, 4-6 weeks ofage) were injected subcutaneously (s.c.) in the right flank with 3×10⁶A431 or NREM cells suspended in 50 μl of PBS. A total of 8 to 10 miceper arm were randomly selected for inoculation when the implanted tumorsreached a median tumor volume of 200 to 300 mm³. Mice were treated withthree doses of 0.3 mg/kg of D2C7-(scdsFv)—PE38 KDEL IT orMR1-1-(scdsFv)-PE38 KDEL IT diluted in 0.2% PBS-HSA, by i.p. injectionsevery other day. The control mice were handled in the same manner andtreated with 0.2% PBS-HSA. Tumors were measured twice weekly with ahandheld vernier caliper, and the tumor volumes were calculated in cubicmillimeters by using the formula: ([length]×[width²])/2. Animals weretested out of the study when tumor volume met both of the followingcriteria: 1) larger than 1000 mm³, and 2) 5 times its original treatmentsize.

Assessment of Response.

The response of the s.c. xenografts was assessed by delay in the growthof tumor in mice treated with drug as compared with growth in controlmice (T-C). The growth delay was the difference between the median timesrequired for tumors in treated (T) and control (C) mice to reach fivetimes the size at the initiation of therapy and at least greater than1000 mm³. Tumor regression was defined as a decrease in tumor volumeover two successive measurements.

Statistical analysis was performed using the Wilcoxon rank-sum test forgrowth delay and Fisher's exact test for tumor regressions as previouslydescribed {Friedman, 1994}.

Example 2 Cloning of the V_(H) and V_(L) Domain of D2C7IgG1κ

V_(H) and V_(L) cDNAs were isolated from the D2C7 hybridoma by a RACEmethod as described in “Materials and Methods.” The heavy-chain andlight-chain variable domains were cloned and sequenced. The amplifiedV_(H) and V_(L) fragments were approximately 360 and 321 bp,respectively. The deduced amino acid sequences of the D2C7 V_(H) andV_(L) domains are shown in FIG. 1. Sequence analysis of the V_(H) andV_(L) amino acids, using the database of germ-line genes(http://www.ncbi.nlm.nih.gov/igblast/), revealed that the sequences werederived from different germ-line V genes with a similarity of 70% to75%.

Example 3 Construction, Expression, and Purification ofD2C7-(scdsFv)-PE38 KDEL Immunotoxin

The carboxyl terminus of the D2C7 V_(H) domain was connected to theamino terminus of the V_(L) domain by a 15-amino-acid peptide (Gly₄Ser)₃linker (SEQ ID NO: 11). In order to obtain a stable IT, it is essentialto ensure that during renaturation V_(H) is positioned near V_(L). Thiswas achieved by mutating a single key residue in each chain to cysteine,for the stabilizing disulfide bond to form. On the basis of predictionsusing molecular modeling and empirical data with other dsFv-recombinantITs, we chose one amino acid in each chain to mutate to cysteine{Reiter, 1996}. These are residues 44 in the framework region 2 (FR2) ofV_(H) and 100 in the FR4 of V_(L) (according to the Kabat numbering).Thus, we prepared an Fv that contains both a peptide linker and adisulfide bond generated by cysteine residues that replace Ser44 ofV_(H) and Gly100 of V_(L). The D2C7 (scdsFv) PCR fragment was then fusedto DNA for domains II and III of Pseudomonas exotoxin A. The version ofPseudomonas exotoxin A used here, PE38 KDEL, has a modified C terminuswhich increases its intracellular retention, in turn enhancing itscytotoxicity. The D2C7-(scdsFv)-PE38 KDEL (FIG. 2) was expressed in E.coli under the control of T7 promoter and harvested as inclusion bodies.The IT was refolded and purified as described in “Materials andMethods.”

Example 4 Antigen Binding Characteristic of D2C7-(scdsFv)-PE38 KDELAntibody

The antigen-binding capability of the D2C7-(scdsFv)-PE38 KDEL IT wasassessed by surface plasmon resonance (Biacore). The purifiedD2C7-(scdsFv)-PE38 KDEL IT was applied to sensor chips that were coatedwith either purified recombinant EGFRwt (FIG. 3A) or EGFRvIII (FIG. 3B)ECD proteins. The D2C7-(scdsFv)-PE38 KDEL IT bound to both the EGFRwt-and the EGFRvIII-ECD-protein-coated chips. Values of the on rates andoff rates were determined for four different concentrations of the IT.The association and dissociation constants of D2C7-(scdsFv)-PE38 KDEL ITon the EGFRwt- and EGFRvIII-coated chips were K_(A)=6.3×10⁸ M⁻¹ andK_(D)=1.6×10⁻⁹ M and K_(A)=7.8×10⁸ M⁻¹ and K_(D)=1.3×10⁻⁹ M,respectively. Thus, the cloned D2C7-(scdsFv)-PE38 KDEL IT binds withsimilar kinetics to both the wild-type and the mutant EGFR proteins.

To determine whether the D2C7-(scdsFv)-PE38 KDEL IT is able to bind tonative EGFRwt and EGFRvIII proteins, indirect flow cytometric analysiswas performed as shown in FIG. 4. FACS analysis revealed that theD2C7-(scdsFv)-PE38 KDEL IT is able to bind to both the EGFRwt-expressingNR6W cells (FIG. 4B) and the EGFRvIII-expressing NR6M cells (FIG. 4C).The parental NR6 cells (FIG. 4A) were used as negative control, whichconfirmed the binding specificity of this toxin. These resultsdemonstrate that the D2C7-(scdsFv)-PE38 KDEL IT is able to bind both tothe purified EGFRwt and the EGFRvIII proteins on a chip and to thenative protein molecules expressed on the surface of transfected cells.

Example 5 Cytotoxicity of D2C7-(scdsFv)-PE38 KDEL IT on TransfectedCells and Cancer Cell Lines

We next examined the effects of D2C7-(scdsFv)-PE38 KDEL IT on EGFRwt- orEGFRvIII-transfected NR6W and NR6M mouse cell lines, respectively. Theability of the D2C7-(scdsFv)-PE38 KDEL IT to inhibit protein synthesiswas used as a measure of its cytotoxic effect. The cytotoxicity ofD2C7-(scdsFv)-PE38 KDEL IT was compared to that of a knownEGFRvIII-specific IT, MR1-1-(scdsFv)-PE38 KDEL (MR1-1) {Beers, 2000} andthat of the parental D2C7-PE38 IT, which lacks the disulfide-stabilizedlinkage and the endoplasmic reticulum retention signal, KDEL. Weinitially evaluated the cytotoxicity of the various ITs to theEGFRwt-expressing NR6W cells. The IC₅₀ of D2C7-(scdsFv)-PE38 KDEL IT onNR6W cells (FIG. 5B) was more than 100-fold lower than that of the MR1-1IT. Even on the NR6M cells (FIG. 5C), a well-established model for MR1-1cytotoxicity {Beers, 2000}, D2C7-(scdsFv)-PE38 KDEL IT had a 1.4-foldlower IC₅₀ value than that of MR-1-1 IT. The IC₅₀ of D2C7-(scdsFv)-PE38KDEL IT was approximately 7-fold lower than that of the parentalD2C7-PE38 IT, against both NR6W and NR6M cells (FIGS. 5B and 5C). All ofthe ITs exhibited no cytotoxicity against the parental NR6 cells (FIG.5A). The cytotoxic effects of D2C7-(scdsFv)-PE38 KDEL IT were alsotested on various EGFRwt- and EGFRvIII-positive human cancer cell lines.The A431P epidermoid carcinoma cell line overexpresses the wild-typeEGFR protein, and the three glioblastoma cell lines D2159MG, D270MG andD256MG express both the EGFRwt and EGFRvIII proteins. As shown in Table1, the D2C7-(scdsFv)-PE38 KDEL IT was more effective than the parentalIT, D2C7-PE38, and the EGFRvIII-targeted IT, MR1-1, in killing all thehuman cancer cell lines tested.

TABLE 1 Cytotoxicity of D2C7 and MR1-1 immunotoxins toward various celllines D2C7- MR1-1- (scdsFv)- (scdsFv)- D2C7-PE38 PE38KDEL PE38KDEL CellLine Cancer type IC₅₀ ng/ml IC₅₀ ng/ml IC₅₀ ng/ml A431 Epidermoid 1.00.170 8.0 D2159MG Glioblastoma 1.8 0.360 0.800 D270MG Glioblastoma 1.80.360 0.580 D256MG Glioblastoma 5.1 0.520 1.9 NOTE: All the cell linesare of human origin. Cytotoxicity data are given as IC₅₀ value, theconcentration of immunotoxin that causes a 50% inhibition of proteinsynthesis after a 20-h incubation with immunotoxin.

Example 6 Nonspecific Toxicity of D2C7-(scdsFv)-PE38 KDEL IT in Mice

The nonspecific toxicity of D2C7-(scdsFv)-PE38 KDEL IT was evaluated inBALB/C mice. Groups of 10 mice were given single i.p. injections ofescalating doses of the IT. The mice were monitored for weight loss,signs of distress, or death for 14 days postinjection. The mortalitydata is shown in Table 2. Almost all of the deaths occurred within 72 hafter treatment. We calculated the LD₁₀ of D2C7-(scdsFv)-PE38 KDEL IT tobe approximately 0.3125 mg/kg. The observed toxicity in mice is due tononspecific uptake of the IT by the liver.

TABLE 2 Toxicity of D2C7-(scdsFv)-PE38KDEL immunotoxin administered toBALB/C mice Dose (mg/kg) Mortality 0.25 0/10 0.5 4/10 0.75 8/10 1.0 9/101.25 10/10  NOTE: Groups of 10 BALB/C mice were injected i.p. with 200μl of escalating doses of the IT diluted in 0.2% PBS-HSA. Animals wereobserved for 14 days. Mortality is expressed as number of deadmice/total number of animals in treatment group.

Example 7 Anti-Tumor Activity of D2C7-(scdsFv)-PE38 KDEL IT In Vivo

To evaluate the anti-tumor activity of the ITs, animals bearing A431tumors were treated with three doses of either D2C7-(scdsFv)-PE38 KDELor MR1-1 (MR1-1 scFv binds with a lower affinity to the wild-type EGFR,unpublished data) at 0.3 mg/kg concentration. Relative to the controlgroup, the D2C7-(scdsFv)-PE38 KDEL-treated mice showed statisticallysignificant growth delay, where T-C was 22 days (p<0.001) (FIG. 6A andTable 3). In contrast, the growth delay in the MR1-1 treated group wasapproximately 4 days (p=0.01) (FIG. 6A and Table 3). The A431 tumorsregressed in 7 of 8 mice treated with D2C7-(scdsFv)-PE38 KDEL, whereasno tumor regression was observed in the MR1-1-treated A431 group. In anin vivo xenograft model of NREM tumors, both D2C7-(scdsFv)-PE38 KDEL andMR1-1 elicited similar responses (FIG. 6B and Table 3). In comparison tothe control group, the D2C7-(scdsFv)-PE38 KDEL-treated group and theMR1-1-treated group had a growth delay of 10 and 9 days, respectively,with a p value of <0.001 (FIG. 6B and Table 3). Tumor regression wasseen in 10 of 10 mice in the D2C7-(scdsFv)-PE38 KDEL-treated group, butonly 6 of 10 mice in the MR1-1-treated group displayed tumor regression.

TABLE 3 In vivo anti-tumor activity of D2C7-(scdsFv)- PE38KDEL andMR1-1-(scdsFv)-PE38KDEL D2C7-(scdsFv)- MR1-1-(scdsFv)- Tumor ControlPE38KDEL PE38KDEL A431 T − C (days) 22.177 3.6875 P <0.001 0.01Regressions 0/8 7/8 0/9 NR6M T − C (days) 10.6565 9.1835 P <0.001 <0.001Regressions  0/10 10/10  6/10 NOTE: Groups of 8 to 10 nude mice bearingA431 or NR6M tumors were treated with 0.3 mg/kg of the IT diluted in0.2% PBS-HSA. T − C denotes the delay in tumor growth in mice treatedwith IT as compared with control mice. Tumor regression was defined as adecrease in tumor volume over two successive measurements.

Example 8

In this study, we have focused on the in vitro and in vivocharacterization of a dual-specificity (EGFRwt/EGFRvIII) IT,D2C7-(scdsFv)-PE38 KDEL. The results from the in vitro cytotoxicityassays showed that D2C7-(scdsFv)-PE38 KDEL is highly effective inkilling a variety of EGFRwt- or EGFRvIII-expressing human tumor celllines. In an animal model of EGFRwt tumors, when administered everyother day for a total of three doses at a concentration of 0.3 mg/kg,the IT inhibited tumor growth, leading to a decrease in tumor volume. Inaddition, D2C7-(scdsFv)-PE38 KDEL was also found to be as effective asthat of an established, affinity-matured, EGFRvIII-targeted IT, MR1-1,in both in vitro and in vivo assays. To the best of our knowledge, thisis the first report demonstrating that a dually specific IT can targetboth the wild-type EGFR and the mutant EGFRvIII.

Different versions of the D2C7 IT were constructed that vastly improvedits efficacy. The parental D2C7-PE38 IT had only a 15-amino-acid peptidelinker between V_(H) and V_(L). The subsequent version of the IT hadboth a 15-amino-acid peptide linker and a disulfide linkage betweenV_(H) and V_(L) [D2C7-(scdsFv)-PE38]. The disulfide linkage helps the ITto fold better, in turn providing improved stability. TheD2C7-(scdsFv)-PE38 IT showed a 2- to 4-fold decrease in IC₅₀ valuescompared to the parental D2C7-PE38 IT (data not shown). Further, whenthe endoplasmic reticulum retention signal KDEL was engineered into thefinal product [D2C7-(scdsFv)-PE38 KDEL], it decreased the IC₅₀ values ofthe IT on all of the cell lines tested by an additional 2-fold. Thus,increasing the stabilization and adding an intracellular retentionsignal enhanced the efficiency of D2C7-(scdsFv)—PE38 KDEL when comparedwith that of the parental D2C7-PE38 IT.

In the in vitro cytotoxicity assays with either the EGFRvIII-transfectedNR6M cells or EGFRvIII-expressing GBM cells, D2C7-(scdsFv)-PE38 KDELoutperformed MR1-1. The difference in IC₅₀ values betweenD2C7-(scdsFv)-PE38 KDEL and MR1-1 was higher in the EGFRwt- andEGFRvIII-co-expressing GBM cells than in the EGFRvIII-expressing NR6Mcells. The presence of both the wild-type and the mutant EGFR proteinson the GBM cells provides a higher concentration of targets on the cellsurface for D2C7-(scdsFv)-PE38 KDEL as opposed to a single target forMR1-1. Hence, on the cells that express both the EGFRwt and EGFRvIIIproteins, D2C7-(scdsFv)-PE38 KDEL exhibited better cytotoxicity thanMR1-1. Also, a competition assay by Biacore analysis with EGFRvIII ECDprotein revealed that D2C7-(scdsFv)-PE38 KDEL and MR1-1 bind todifferent epitopes (data not shown). Thus, the availability of theepitopes on the cell surface for the ITs to bind might also play a rolein the observed difference in cytotoxicity between D2C7-(scdsFv)-PE38KDEL and MR1-1.

Several anti-EGFR mAbs that have demonstrated antitumor activity againstEGFR-expressing human tumor cells in mouse xenograft models and/orculture have been developed {Laskin, 2004}. Some of these anti-EGFR mAbsare in clinical trials for a variety of human cancers, including headand neck, colorectal, pancreatic, lung, renal cell or prostatecarcinoma, or high-grade glioma {Boskovitz, 2004; Laskin, 2004}.Anti-EGFRwt mAbs EGFR1, H17E2, and mAb 425 were the first to beintroduced in targeted radiotherapy trials that involved systemicinjection of radiolabeled mAb in patients with malignant glioma {Brady,1992; Epenetos, 1985; Kalofonos, 1989}. The anti-EGFR mAbs that arecurrently in Phase II trials for patients with high-grade glioma include¹²⁵I-labeled mAb 425 in combination with surgery, radiation therapy andchemotherapy (Protocol IDs: 12555, NCT00589706), which has alreadydemonstrated an increase in median survival {Quang, 2004}. Further, arecombinant EGFR ligand (transforming growth factor-α) Pseudomonasexotoxin fusion protein (TP-38) has also been tested in Phase I clinicaltrials for treating malignant gliomas {Sampson, 2008}.

Because of the truly tumor-specific nature of EGFRvIII, both polyclonalantibodies and mAbs directed against this mutant form of EGFR have beendeveloped {Humphrey, 1990; Wikstrand, 1995}. The development of mAbs andsingle-chain fragment antibody constructs specific for the mutantEGFRvIII, including L8A4, Y10, P14, X32, MR1, MR1-1, and 14E1, has beenwell described {Beers, 2000; Kuan, 1999; Kuan, 2000; Reist, 1995;Schmidt, 1999; Wikstrand, 1995; Wikstrand, 1997}. Among the variousantibody constructs, the one with enormous potential is the MR1single-chain antibody fragment, as well as its affinity-maturedderivative MR1-1 {Beers, 2000; Kuan, 1999; Kuan, 2000}. MR1-1, whichdiffers from the parental MR1 by three amino acid residues (one inV_(L)CDR3 [F92W] and two in V_(H)CDR3 [S98P, T99Y]), has a 15-foldgreater K_(D) (1.5×10⁻⁹ M) for the extracellular domain of EGFRvIII thandoes MR1 {Kuan, 2000}. A Phase I clinical study with the MR1-1 IT iscurrently underway for the treatment of patients withEGFRvIII-overexpressing GBM tumors. Due to the recurrent nature ofmalignant gliomas, as well as the diversity of antigens populating theglioma cell surface, innovative therapies are needed.

The EGFRvIII mutation occurs in 52% of all human GBMs and isco-expressed in 50% to 60% of tumors that have EGFRwt amplification{Frederick, 2000; Wikstrand, 1995}. Thus, it would be advantageous tohave antibodies that could target both EGFRwt and EGFRvIII antigens forGBM therapy. This could be achieved by co-targeting these two antigenswith a bispecific scFv antibody, an scFv antibody that has dualspecificity. This could promote increased targeting of the tumor overantibodies specific for a single antigen. No bispecific scFv that cantarget both EGFRwt and EGFRvIII has been reported, although reports havebeen published describing two mAbs, mAb 528 and mAb 806, with dualspecificity for the wild-type and mutant EGFR proteins expressed ondifferent cell lines. The mAb 528 is an IgG2a antibody that was raisedagainst EGFR by using the epidermoid carcinoma cell line A431 {Masui,1984}. This antibody binds both the EGFRwt expressed on A431 cells andEGFRvIII expressed on U87MG.Δ2-7 {Perera, 2005}. Monoclonal antibody 528competes with EGF binding to the receptor and inhibits the growth ofEGFR-expressing cells both in vitro and in vivo {Masui, 1984}. The IgG2bmAb 806 is an EGFR-specific antibody that was raised in mice immunizedwith NR6 cells transfected with EGFRvIII {Johns, 2002}. The mAb 806binds EGFRvIII with high affinity and EGFRwt at a low percentage (10%)on A431 cells {Johns, 2002}. A humanized form of the mAb 806 (ch806) wasused in Phase I clinical trials for patients with diverse tumor typesexpressing EGFR {Scott, 2007}. Combination therapy with the mAbs 528 and806 was performed with xenografts expressing EGFRwt or EGFRvIII. Asignificant decrease in tumor volume was observed when the mAbs wereadministered in combination {Perera, 2005}. In our in vivo models, thetumor growth inhibition by D2C7-(scdsFv)-PE38 KDEL at 3 doses wascomparable to the response observed with the mAbs 528 and 806 together,for a total of 6 doses. Hence, the dual-specificity IT is likely moreefficacious than the combined mAb treatment. Moreover, treating braintumors that co-express EGFRwt and EGFRvI1I with D2C7-(scdsFv)-PE38 KDELIT will address the concern that expression of EGFRvIII may causeresistance to EGFR antibody therapy. Thus, a single antibody withspecificity against two different tumor antigens eliminates thenecessity for multiple therapeutics to treat tumor.

In conclusion, we have created a dual specific-scFv molecule that iscapable of mediating selective in vitro and in vivo tumor targeting.Further, we believe this to be the first significant evidence ofenhanced tumor targeting with high selectivity and specificity by anantibody specific for two tumor-associated antigens. Taken together, ourresults suggest that the bispecific antibody D2C7-(scdsFv)-PE38 KDEL maybe efficacious in vivo against brain tumors.

REFERENCES

The disclosure of each reference cited is expressly incorporated herein.

-   1. Louis D N, Gusella J F. A tiger behind many doors: multiple    genetic pathways to malignant glioma. Trends Genet. 1995; 11: 412-5.-   2. Walker M D, Alexander E, Jr., Hunt W E, et al. Evaluation of BCNU    and/or radiotherapy in the treatment of anaplastic gliomas. A    cooperative clinical trial. Journal of neurosurgery 1978; 49:    333-43.-   3. Levin V A, Wara W M, Davis R L, et al. Phase III comparison of    BCNU and the combination of procarbazine, CCNU, and vincristine    administered after radiotherapy with hydroxyurea for malignant    gliomas. Journal of neurosurgery 1985; 63: 218-23.-   4. Stupp R, Hegi M E, Gilbert M R, Chakravarti A. Chemoradiotherapy    in malignant glioma: standard of care and future directions. J Clin    Oncol 2007; 25: 4127-36.-   5. Boskovitz A, Wikstrand C J, Kuan C T, Zalutsky M R, Reardon D A,    Bigner D D. Monoclonal antibodies for brain tumour treatment. Expert    opinion on biological therapy 2004; 4: 1453-71.-   6. Archer G E, Sampson J H, Lorimer I A, et al. Regional treatment    of epidermal growth factor receptor vIII-expressing neoplastic    meningitis with a single-chain immunotoxin, MR-1. Clin Cancer Res    1999; 5: 2646-52.-   7. Pastan I H, Archer G E, McLendon R E, et al. Intrathecal    administration of single-chain immunotoxin, LMB-7 [B3(Fv)-PE38],    produces cures of carcinomatous meningitis in a rat model.    Proceedings of the National Academy of Sciences of the United States    of America 1995; 92: 2765-9.-   8. Ushiro H, Cohen S. Identification of phosphotyrosine as a product    of epidermal growth factor-activated protein kinase in A-431 cell    membranes. The Journal of biological chemistry 1980; 255: 8363-5.-   9. Klijn J G, Berns P M, Schmitz P I, Foekens J A. The clinical    significance of epidermal growth factor receptor (EGF-R) in human    breast cancer: a review on 5232 patients. Endocrine reviews 1992;    13: 3-17.-   10. Osaki A, Toi M, Yamada H, Kawami H, Kuroi K, Toge T. Prognostic    significance of co-expression of c-erbB-2 oncoprotein and epidermal    growth factor receptor in breast cancer patients. American journal    of surgery 1992; 164: 323-6.-   11. Pavelic K, Banjac Z, Pavelic J, Spaventi S. Evidence for a role    of EGF receptor in the progression of human lung carcinoma.    Anticancer research 1993; 13: 1133-7.-   12. Rubin Grandis J, Melhem M F, Barnes E L, Tweardy D J.    Quantitative immunohistochemical analysis of transforming growth    factor-alpha and epidermal growth factor receptor in patients with    squamous cell carcinoma of the head and neck. Cancer 1996; 78:    1284-92.-   13. Fox S B, Persad R A, Coleman N, Day C A, Silcocks P B, Collins    C C. Prognostic value of c-erbB-2 and epidermal growth factor    receptor in stage A1 (T1a) prostatic adenocarcinoma. British journal    of urology 1994; 74: 214-20.-   14. Chow N H, Chan S H, Tzai T S, Ho C L, Liu H S. Expression    profiles of ErbB family receptors and prognosis in primary    transitional cell carcinoma of the urinary bladder. Clin Cancer Res    2001; 7: 1957-62.-   15. Yasui W, Sumiyoshi H, Hata J, et al. Expression of epidermal    growth factor receptor in human gastric and colonic carcinomas.    Cancer research 1988; 48: 137-41.-   16. Bartlett J M, Langdon S P, Simpson B J, et al. The prognostic    value of epidermal growth factor receptor mRNA expression in primary    ovarian cancer. British journal of cancer 1996; 73: 301-6.-   17. Arita N, Hayakawa T, Izumoto S, et al. Epidermal growth factor    receptor in human glioma. Journal of neurosurgery 1989; 70: 916-9.-   18. Libermann T A, Razon N, Bartal A D, Yarden Y, Schlessinger J,    Soreq H. Expression of epidermal growth factor receptors in human    brain tumors. Cancer research 1984; 44: 753-60.-   19. Fuller G N, Bigner S H. Amplified cellular oncogenes in    neoplasms of the human central nervous system. Mutation research    1992; 276: 299-306.-   20. Chaffanet M, Chauvin C, Laine M, et al. EGF receptor    amplification and expression in human brain tumours. Eur J Cancer    1992; 28: 11-7.-   21. Huang S M, Harari P M. Epidermal growth factor receptor    inhibition in cancer therapy: biology, rationale and preliminary    clinical results. Investigational new drugs 1999; 17: 259-69.-   22. Rasheed B K, Wiltshire R N, Bigner S H, Bigner D D. Molecular    pathogenesis of malignant gliomas. Current opinion in oncology 1999;    11: 162-7.-   23. Wikstrand C J, Reist C J, Archer G E, Zalutsky M R, Bigner D D.    The class III variant of the epidermal growth factor receptor    (EGFRvIII): characterization and utilization as an immunotherapeutic    target. Journal of neurovirology 1998; 4: 148-58.-   24. Sugawa N, Ekstrand A J, James C D, Collins V P. Identical    splicing of aberrant epidermal growth factor receptor transcripts    from amplified rearranged genes in human glioblastomas. Proceedings    of the National Academy of Sciences of the United States of America    1990; 87: 8602-6.-   25. Batra S K, Castelino-Prabhu S, Wikstrand C J, et al. Epidermal    growth factor ligand-independent, unregulated, cell-transforming    potential of a naturally occurring human mutant EGFRvIII gene. Cell    Growth Differ 1995; 6: 1251-9.-   26. Humphrey P A, Wong A J, Vogelstein B, et al. Anti-synthetic    peptide antibody reacting at the fusion junction of deletion-mutant    epidermal growth factor receptors in human glioblastoma. Proceedings    of the National Academy of Sciences of the United States of America    1990; 87: 4207-11.-   27. Sok J C, Coppelli F M, Thomas S M, et al. Mutant epidermal    growth factor receptor (EGFRvIII) contributes to head and neck    cancer growth and resistance to EGFR targeting. Clin Cancer Res    2006; 12: 5064-73.-   28. Wikstrand C J, Hale L P, Batra S K, et al. Monoclonal antibodies    against EGFRvIII are tumor specific and react with breast and lung    carcinomas and malignant gliomas. Cancer research 1995; 55: 3140-8.-   29. Nagane M, Levitzki A, Gazit A, Cavenee W K, Huang H J. Drug    resistance of human glioblastoma cells conferred by a tumor-specific    mutant epidermal growth factor receptor through modulation of Bc1-XL    and caspase-3-like proteases. Proceedings of the National Academy of    Sciences of the United States of America 1998; 95: 5724-9.-   30. Boskovitz A, Pegram, C, Peixoto, K, Zalutsky, M. R. and    Bigner, D. D. Pre-clinical evaluation of D2C7, a monoclonal antibody    reactive for both the wild type and variant III mutant epidermal    growth factor receptor, for radioimmunotherapy of malignant gliomas    World federation of neuro-oncology second quadrennial meeting and    the sixth meeting of the european association for neuro-oncology.    Edinburgh, United Kingdom; 2005.-   31. Merlino G T, Xu Y H, Ishii S, et al. Amplification and enhanced    expression of the epidermal growth factor receptor gene in A431    human carcinoma cells. Science (New York, N.Y. 1984; 224: 417-9.-   32. Buchner J, Pastan I, Brinkmann U. A method for increasing the    yield of properly folded recombinant fusion proteins: single-chain    immunotoxins from renaturation of bacterial inclusion bodies.    Analytical biochemistry 1992; 205: 263-70.-   33. Beers R, Chowdhury P, Bigner D, Pastan I. Immunotoxins with    increased activity against epidermal growth factor receptor    vIII-expressing cells produced by antibody phage display. Clin    Cancer Res 2000; 6: 2835-43.-   34. Friedman H S, Houghton P J, Schold S C, Keir S, Bigner D D.    Activity of 9-dimethylaminomethyl-10-hydroxycamptothecin against    pediatric and adult central nervous system tumor xenografts. Cancer    chemotherapy and pharmacology 1994; 34: 171-4.-   35. Reiter Y, Brinkmann U, Lee B, Pastan I. Engineering antibody Fv    fragments for cancer detection and therapy: disulfide-stabilized Fv    fragments. Nature biotechnology 1996; 14: 1239-45.-   36. Laskin J J, Sandler A B. Epidermal growth factor receptor: a    promising target in solid tumours. Cancer treatment reviews 2004;    30:1-17.-   37. Brady L W, Miyamoto C, Woo D V, et al. Malignant astrocytomas    treated with iodine-125 labeled monoclonal antibody 425 against    epidermal growth factor receptor: a phase II trial. International    journal of radiation oncology, biology, physics 1992; 22: 225-30.-   38. Epenetos A A, Courtenay-Luck N, Pickering D, et al. Antibody    guided irradiation of brain glioma by arterial infusion of    radioactive monoclonal antibody against epidermal growth factor    receptor and blood group A antigen. British medical journal    (Clinical research ed 1985; 290: 1463-6.-   39. Kalofonos H P, Pawlikowska T R, Hemingway A, et al. Antibody    guided diagnosis and therapy of brain gliomas using radiolabeled    monoclonal antibodies against epidermal growth factor receptor and    placental alkaline phosphatase. J Nucl Med 1989; 30: 1636-45.-   40. Quang T S, Brady L W. Radioimmunotherapy as a novel treatment    regimen: 125I-labeled monoclonal antibody 425 in the treatment of    high-grade brain gliomas. International journal of radiation    oncology, biology, physics 2004; 58: 972-5.-   41. Sampson J H, Akabani G, Archer G E, et al. Intracerebral    infusion of an EGFR-targeted toxin in recurrent malignant brain    tumors. Neuro-oncology 2008; 10: 320-9.-   42. Kuan C T, Reist C J, Foulon C F, et al. 125I-labeled    anti-epidermal growth factor receptor-vIII single-chain Fv exhibits    specific and high-level targeting of glioma xenografts. Clin Cancer    Res 1999; 5: 1539-49.-   43. Kuan C T, Wikstrand C J, Archer G, et al. Increased binding    affinity enhances targeting of glioma xenografts by    EGFRvIII-specific scFv. International journal of cancer 2000; 88:    962-9.-   44. Reist C J, Archer G E, Kurpad S N, et al. Tumor-specific    anti-epidermal growth factor receptor variant III monoclonal    antibodies: use of the tyramine-cellobiose radioiodination method    enhances cellular retention and uptake in tumor xenografts. Cancer    research 1995; 55: 4375-82.-   45. Schmidt M, Maurer-Gebhard M, Groner B, Kohler G,    Brochmann-Santos G, Wels W. Suppression of metastasis formation by a    recombinant single chain antibody-toxin targeted to full-length and    oncogenic variant EGF receptors. Oncogene 1999; 18: 1711-21.-   46. Wikstrand C J, McLendon R E, Friedman A H, Bigner D D. Cell    surface localization and density of the tumor-associated variant of    the epidermal growth factor receptor, EGFRvIII. Cancer research    1997; 57: 4130-40.-   47. Frederick L, Wang X Y, Eley G, James C D. Diversity and    frequency of epidermal growth factor receptor mutations in human    glioblastomas. Cancer research 2000; 60: 1383-7.-   48. Masui H, Kawamoto T, Sato J D, Wolf B, Sato G, Mendelsohn J.    Growth inhibition of human tumor cells in athymic mice by    anti-epidermal growth factor receptor monoclonal antibodies. Cancer    research 1984; 44: 1002-7.-   49. Perera R M, Narita Y, Furnari F B, et al. Treatment of human    tumor xenografts with monoclonal antibody 806 in combination with a    prototypical epidermal growth factor receptor-specific antibody    generates enhanced antitumor activity. Clin Cancer Res 2005; 11:    6390-9.-   50. Johns T G, Stockert E, Ritter G, et al. Novel monoclonal    antibody specific for the de2-7 epidermal growth factor receptor    (EGFR) that also recognizes the EGFR expressed in cells containing    amplification of the EGFR gene. International journal of cancer    2002; 98: 398-408.-   51. Scott A M, Lee F T, Tebbutt N, et al. A phase I clinical trial    with monoclonal antibody ch806 targeting transitional state and    mutant epidermal growth factor receptors. Proceedings of the    National Academy of Sciences of the United States of America 2007;    104: 4071-6.

1. A single chain variable region antibody which binds with a bindingaffinity that is at least 5×10⁸ M⁻¹ as measured by surface plasmonresonance to both (a) EGFR found on normal human cells and (b) EGFRvariant III mutant.
 2. The single chain variable region antibody ofclaim 1 which is cloned from a hybridoma producing a monoclonal antibodyselected from the group consisting of D2C7, F2A2, B10B11, and H11. 3.The single chain variable region antibody of claim 1 which is covalentlylinked to a cytotoxic agent selected from the group consisting of atoxin, a chemotherapeutic agent, and a radionuclide.
 4. The single chainvariable region antibody of claim 3 wherein the agent is a toxin whichis produced as a fusion protein with the single chain variable regionantibody.
 5. The single chain variable region antibody of claim 4wherein the monoclonal antibody is D2C7.
 6. The single chain variableregion antibody of claim 3 wherein the agent is a form of Pseudomonasexotoxin A.
 7. The single chain variable region antibody of claim 6further comprising a KDEL peptide.
 8. The single chain variable regionantibody of claim 1 which has a VH sequence as shown in FIG. 1A
 9. Thesingle chain variable region antibody of claim 1 which as a VL sequenceas shown in FIG. 1B.
 10. The single chain variable region antibody ofclaim 1 which has CDR1, CDR2, and CDR3 regions as shown in FIGS. 1A and1B.
 11. The single chain variable region antibody of claim 1 whereinsaid binding affinity is at least 6×10⁸ M⁻¹.
 12. The single chainvariable region antibody of claim 1 wherein said binding affinity isbetween 5×10⁸ M⁻¹ and 5×10⁹ M⁻¹.
 13. The single chain variable regionantibody of claim 1 which has an IC50 of less than 2 ng/ml for humancells expressing EGFR as found on normal cells or EGFRvIII.
 14. Thesingle chain variable region antibody of claim 1 which has an IC₅₀ ofless than 1.5 ng/ml for human cells expressing EGFR as found on normalcells or EGFRvIII.
 15. The single chain variable region antibody ofclaim 1 which has an IC₅₀ of less than 1 ng/ml for human cellsexpressing EGFR as found on normal cells or EGFRvIII.
 16. The singlechain variable region antibody of claim 1 which has an IC₅₀ of less than0.5 ng/ml for human cells expressing EGFR as found on normal cells orEGFRvIII.
 17. A method of treating a tumor in a human, comprising:administering a single chain variable region antibody according to claim1 to the human, whereby tumor cells are killed.
 18. The method of claim17 wherein the tumor is a squamous cell head and neck tumor.
 19. Themethod of claim 17 wherein the tumor is a brain tumor.
 20. The method ofclaim 17 wherein the tumor is a breast tumor.
 21. The method of claim 17wherein the tumor is a glioblastoma multiforme.
 22. The method of claim17 wherein the tumor is an astrocytoma.
 23. The method of claim 17wherein the tumor contains an EGFRvIII allele.
 24. The method of claim17 wherein the administering is directly to the central nervous system.25. The method of claim 17 wherein the administering is directly to thebrain.
 26. The method of claim 17 wherein the administering is directlyto a surgically-created tumor resection cavity.
 27. The method of claim17 wherein the administering is directly to a natural tumor cyst. 28.The method of claim 17 wherein the administering is directly to tumorparenchyma.
 29. A monoclonal antibody which binds with a bindingaffinity that is at least 5×10⁸ M⁻¹ to both (a) EGFR found on normalhuman cells and (b) EGFR variant III mutant, wherein said antibody has aVH sequence as shown in FIG. 1A, a VL sequence as shown in FIG. 1B, orCDR1, CDR2, and CDR3 regions as shown in FIGS. 1A and 1B.
 30. Themonoclonal antibody of claim 29 which is designated D2C7.
 31. Themonoclonal antibody of claim 29 which comprises a human IgG.
 32. Amonoclonal antibody which binds with a binding affinity that is at least1×10⁸ M⁻¹ to both (a) EGFR found on normal human cells and (b) EGFRvariant III mutant, wherein said antibody is selected from the groupconsisting of F2A2 and B10B11.
 33. A method of treating a tumor in ahuman, comprising: administering an antibody according to claim 29, 30,31, or 32, to the human whereby tumor cells are killed.
 34. A method ofdetermining therapeutic plan to treat a tumor in a human, comprising:contacting tissue of the tumor with an antibody according to claim 1,29, 30, 31, or 32; determining amount of cells in the tissue which bindto the antibody, wherein greater amounts of cells which bind are apositive factor to recommend using the antibody therapeutically for thepatient.